Risk factors for fracture among current, persistent users of bisphosphonates

E. S. LeBlanc, A. G. Rosales, A. Balasubramanian, C. D. O’Malley, O. Egbuna, Darin Friess, N. A. Perrin

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Introduction: Bisphosphonate therapy reduces but does not eliminate fracture occurrence. The incidence of fracture and risk factors for fractures among persistent, current users of bisphosphonates in a community setting have not been well studied.

Summary: Bisphosphonate therapy reduces fracture risk but does not eliminate fracture occurrence. We determined the fracture incidence and risk factors for fractures among 14,674 bisphosphonate users in a community setting. Bisphosphonate users remained at risk of fracture, and additional measures to prevent fractures in these patients would be beneficial.

Methods: We conducted a retrospective cohort study of 14,674 bisphosphonate users in a health maintenance organization. Patients were followed until a 3-month gap in therapy, creating a pool of highly compliant [mean medication possession ratio (MPR) of 94 %] current users. We used Cox proportional hazards models to identify risk factors for fractures among these persistent, current users.

Results: There were 867 fractures over the period of observation or 3.7 fractures per 100 users per year. Older patients who take multiple medications, have lower bone mineral density, have a history of prior fracture, and suffer from particular comorbidities (i.e., dementia, chronic kidney disease, and rheumatoid arthritis) are at higher risk of fracture while taking bisphosphonates.

Conclusion: Persistent, current bisphosphonate users remain at risk of fracture, and additional measures to prevent fractures in these patients would be of benefit.

Original languageEnglish (US)
Pages (from-to)713-725
Number of pages13
JournalOsteoporosis International
Volume26
Issue number2
DOIs
StatePublished - 2014

Keywords

  • Bisphosphonates
  • Fractures
  • Osteoporosis
  • Risk factors

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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    LeBlanc, E. S., Rosales, A. G., Balasubramanian, A., O’Malley, C. D., Egbuna, O., Friess, D., & Perrin, N. A. (2014). Risk factors for fracture among current, persistent users of bisphosphonates. Osteoporosis International, 26(2), 713-725. https://doi.org/10.1007/s00198-014-2941-9